Does lack of brain injury mean lack of cognitive impairment in traumatic spinal cord injury?

Objective: Traumatic spinal cord injury (tSCI) has implications in many areas, including cognitive functioning. Findings regarding cognitive problems in people with SCI are inconsistent, presumably due to multiple variables than can affect performance, among them emotional variables. The purpose of the current study was to elucidate cognitive sequalae in some individuals with tSCI with no medical record of brain injury, while taking emotional variables into consideration. Design: Cross-sectional, with two groups. Setting: A public rehabilitation center. Participants: Twenty participants with tSCI at least ten months post injury and twenty non-SCI controls, matched for sex, age, and education. Intervention: None. Outcome Measures: A battery of neuropsychological tests tapping executive functions, memory, attention, and naming abilities, in addition to questionnaires assessing depression and distress. Results: When emotional variables were statistically controlled, participants with tSCI showed higher levels of depression and distress and scored lower than non-SCI control participants on all cognitive tests except naming. Executive functions were found to have the highest effect size, though no specific ability was sensitive enough to differentiate between the groups in a binary logistic regression analysis. Conclusion: In some individuals with chronic tSCI, lower cognitive ability that is unrelated to emotional distress might result from spinal cord damage and its implications in a population who’s medical records show no indication of brain injury. This highlights the importance of conducting cognitive evaluation following SCI, so that deficits can be effectively addressed during rehabilitation.